The American Psychiatric Association published the first "Diagnostic and Statistical Manual of Mental Disorders" in 1952. There have been several revisions of the publication since that time, and an update of the DSM is due out in 2012. The DSM is a classification system of over 300 mental health disorders and is used by professionals in the field of mental health and psychiatry. Disorders are classified on a multi-axial system of five categories. Axis I is diagnosable clinical mental and learning disorders. Axis II includes personality disorders. Axis III refers to acute medical or physical disorders. Axis IV and V are psychosocial and environmental factors contributing to the disorder and an assessment of functioning. The Axis I and II disorders are the primary focus of psychiatric treatment; however, the additional axis information is also pertinent in considering course of care.
Anxiety Disorders
Anxiety and mood disorders are classified as Axis I in the DSM. Anxiety disorders are characterized by feelings that range from uneasiness to terror. There are different types of anxiety disorders, such as general anxiety disorder and post-traumatic stress disorder. Diagnostic criteria for general anxiety disorder includes excessive worry occurring for more than six months.There is no specific focus of worry for generalized anxiety disorder, but the symptoms are persistent and followed by additional markers such as fatigue and irritability. Post-traumatic stress disorder, or PTSD, is a specific anxiety disorder resulting from witnessing or being the victim of a traumatic event. Certain symptoms such as flashbacks, hypervigilance and emotional numbness are associated with PTSD.
Schizophrenia
Schizophrenia is an Axis I disorder characterized by positive and negative symptoms. Positive symptoms include bizarre thoughts and hallucinations, while negative symptoms refer to social withdrawal, emotionless expression and diminished motivation. There are five types of schizophrenia diagnoses listed in the DSM-IV-TR, but the American Psychiatric Association indicates that this list will be revised in the new DSM.
Personality Disorders
Personality disorders are characterized as Axis II disorders grouped into three clusters by commonality in symptoms. Cluster A is composed of odd or eccentric behaviors, cluster B is dramatic and erratic behaviors and cluster C is comprised of anxious and fearful behaviors. The personality disorders impair a person's functioning in daily life and social relationships. Depending on the specific disorder, the personalities are described as potentially hostile and detached or needy and obsessive. Paranoid personality, antisocial personality and dependent personality are all diagnoses from Axis II personality disorders.
